4 CALIFORNIA STATE UNIVERSITY, CHICO SCHOOL OF NURSING INTRODUCTION The faculty of the School of Nursing at California State University, Chico would like to welcome you to the Nursing Program. We know you will find the study of nursing interesting and rewarding. The course of study is demanding and we would like to help you achieve your goal. The guidelines in this booklet are a supplement to the "University Catalog" and evolved over years of student and faculty participation in the nursing curriculum of California State University, Chico. They were developed to help you understand certain expectations of this nursing curriculum. Your suggestions to make these "Guidelines" continuously useful are welcomed. Successful completion of the program leads to the B.S. in Nursing. The program combines both general and professional education to prepare a well-educated citizen who is also a professional practitioner. The program is accredited by the State of California Board of Registered Nursing and by the Commission on Collegiate Nursing Education. Graduates of the program are eligible to apply for the State of California Public Health Nursing Certificate. The School of Nursing is an integral unit of the College of Natural Sciences at California State University, Chico, and, in accord with the primary goal of the University, provides a quality education. The School of Nursing further subscribes to the University's commitment to serve the population of northeastern California. MISSION OF THE SCHOOL OF NURSING The mission of the School of Nursing is to offer baccalaureate and master s programs in nursing that prepare graduates as generalists in professional nursing, as nursing educators, and as leaders/managers for diverse healthcare settings. As such, the school provides high quality, student-centered learning environments that incorporate evidence based care and the use of clinical reasoning. The school supports faculty and student scholarly activities and encourages lifelong learning. The school also fosters service to others through our extensive community and regional collaboration with external healthcare stakeholders. UNIVERSITY GOALS AND STRATEGIC PRIORITIES The University, College of Natural Sciences, and School of Nursing have identified six goals known as strategic priorities, which are as follows: Strategic Priority #1: Believing in the primacy of student learning, we will continue to develop high quality learning environments both in and outside of the classroom. Strategic Priority #2: Believing in the importance of faculty and staff, and their role in student success, we will continue to invest in faculty and staff development. 4

5 Strategic Priority #3: Believing in the value of the wise use of new technologies in learning and teaching, we will continue to provide the technology, the related training, and the support needed to create high quality learning environments both in and outside of the classroom. Strategic Priority #4: Believing in the value of service to others, we will continue to serve the educational, cultural, and economic needs of Northern California. Strategic Priority #5: Believing that we are accountable to the people of the State of California, we will continue to diversify our sources of revenue and manage the resources entrusted to us. Strategic Priority #6: Believing that each generation owes something to those that follow, we will create environmentally literate citizens who embrace sustainability as a way of living. We will be wise stewards of scarce resources and, in seeking to develop the whole person, be aware that our individual and collective actions have economic, social, and environmental consequences locally, regionally, and globally. ORGANIZING FRAMEWORK OF THE SCHOOL OF NURSING A visual depiction of the mission, vision, values, strategies, program structural elements, curricular foundations, and student learning outcomes for the undergraduate nursing program at CSU, Chico are noted on the following page. These elements provide the foundation for the development of the undergraduate curriculum and are consistent with the mission and goals of the College of Natural Sciences and the university. 5

6 UTCOMES FOR BSN GRADUATES 6

7 Baccalaureate graduates of the CSU, Chico School of Nursing will: 1) Demonstrate effective written and verbal communication skills. 2) Influence the quality of nursing and health care within practice settings through the use of leadership skills, management concepts, and knowledge of the political system. 3) Use scientific knowledge, research, and nursing theory as the basis for professional nursing practice. 4) Demonstrate competency in the application of technology in the provision of nursing care. 5) Demonstrate information literacy skills in planning and implementing quality nursing interventions. 6) Apply critical thinking skills as the basis for making judgments for professional nursing practice. 7) Apply the nursing process in the provision of care for individuals, families, groups, and community in a variety of settings. 8) Demonstrate accountability for legal scope of practice, professional standards of practice, and professional code of ethics. 9) Demonstrate cultural competency in the provision of nursing care. 10) Collaborate with health care providers and consumers to promote the health and well-being of people across the life span. The curriculum for the CSUC School of Nursing provides the following content identified by the American Association of Colleges of Nursing as essential to BSN education. BSN ESSENTIALS Essential I: Liberal education for baccalaureate generalist nursing practice. Essential II: Basic organizational and systems leadership for quality care and patient safety. Essential III: Scholarship for evidence-based practice. Essential IV: Information management and application of patient care technology. Essential V: Healthcare policy, finance, and regulatory environments. Essential VI: Interprofessional communication and collaboration for improving patient health outcomes. Essential VII: Clinical prevention and population health. Essential VIII: Professionalism and professional values. Essential IX: Baccalaureate generalist nursing practice. 7

8 NURSING STANDARDS AND PROFESSIONAL BEHAVIOR EXPECTATIONS The American Nurses Association has defined standards and codes by which all nurses practice (ANA, 2010). As a professional program, students must demonstrate behaviors that reflect the defined standards of nursing throughout their academic experience. ANA Standards of Nursing Practice Standard 1. Assessment The registered nurse collects comprehensive data pertinent to the healthcare consumer s health or the situation. Competencies The registered nurse: Collects comprehensive data including but not limited to physical, functional, psychosocial, emotional, cognitive, sexual, cultural, age-related, environmental, spiritual/transpersonal, and economic assessments in a systematic and ongoing process while honoring the uniqueness of the person. Elicits the healthcare consumer s values, preferences, expressed needs, and knowledge of the healthcare situation. Involves the healthcare consumer, family, and other healthcare providers as appropriate, in holistic data collection. Identifies barriers (e.g. psychosocial, literacy, financial, cultural) to effective communication and makes appropriate adaptations. Recognizes the impact of personal attitudes, values, and beliefs. Assesses family dynamics and impact on healthcare consumer health and wellness. Prioritizes data collection based on the healthcare consumer s immediate condition, or the anticipated needs of the healthcare consumer or situation. Uses appropriate evidence-based assessment techniques, instruments, and tools. Synthesizes available data, information, and knowledge relevant to the situation to identify patterns and variances. Applies ethical, legal, and privacy guidelines and policies to the collection, maintenance, use, and dissemination of data and information. Recognizes the healthcare consumer as the authority on her or his own health by honoring their care preferences. Documents relevant data in a retrievable format. Standard 2. Diagnosis The registered nurse analyzes the assessment data to determine the diagnoses or issues. Competencies The registered nurse: Derives the diagnoses or issues from assessment data. Validates the diagnoses or issues with the healthcare consumer, family, and other healthcare providers when possible and appropriate. Identifies actual or potential risks to the healthcare consumer s health and safety or barriers to health, which may include but are not limited to interpersonal, systematic, or environmental circumstances. 8

9 Uses standardized classification systems and clinical decision support tools, when available, in identifying diagnoses. Documents diagnoses or issues in a manner that facilitates the determination of the expected outcomes and plan. Standard 3. Outcomes Identification The registered nurse identifies expected outcomes for a plan individualized to the healthcare consumer or the situation. Competencies The registered nurse: Involves the healthcare consumer, family, healthcare providers, and others in formulating expected outcomes when possible and appropriate. Derives culturally appropriate expected outcomes from the diagnoses. Considers associated risks, benefits, costs, current scientific evidence, expected trajectory of the condition, and clinical expertise when formulating expected outcomes. Defines expected outcomes in terms of the healthcare consumer, healthcare consumer cultural, values, and ethical considerations. Includes a time estimate for attainment of expected outcomes. Develops expected outcomes that facilitate continuity of care. Modifies expected outcomes according to changes in the status of the healthcare consumer or evaluation of the situation. Documents expected outcomes as measurable goals. Standard 4. Planning The registered nurse develops a plan that prescribes strategies and alternatives to attain expected outcomes. Competencies The registered nurse: Develops an individualized plan in partnership with the person, family, and others considering the person s characteristics or situation, including, but not limited to values, beliefs, spiritual and health practices, preferences, choices, developmental level, coping style, culture and environment, and available technology. Establishes the plan priorities with the healthcare consumer, family, and others, as appropriate. Includes strategies in the plan that address each of the identified diagnoses or issues. These may include, but are not limited to, strategies for: promotion and restoration of health; prevention of illness, injury, and disease; the alleviation of suffering; and supportive care for those who are dying. Includes strategies for health and wholeness across the lifespan. Provides for continuity in the plan. Incorporates an implementation pathway or timeline in the plan. Considers the economic impact of the plan on the healthcare consumer, family, caregivers, or other affected parties. Integrates current scientific evidence, trends, and research. Utilizes the plan to provide direction to other members of the healthcare team. Explores practice settings and safe space and time for the nurse and the healthcare consumer to explore suggested, potential, and alternative options. Defines the plan to reflect current statutes, rules and regulations, and standards. Modifies the plan according to the ongoing assessment of the health care consumer s response and other outcome indicators. Documents the plan in a manner that uses standardized language or recognized terminology. 9

10 Standard 5. Implementation The registered nurse implements the identified plan. Competencies The registered nurse: Partners with the person, family, significant others, and caregivers as appropriate to implement the plan in a safe, realistic, and timely manner. Demonstrates caring behaviors toward healthcare consumers, significant others, and groups of people receiving care. Utilizes technology to measure, record, and retrieve healthcare consumer data, implement the nursing process, and enhance nursing practice. Utilizes evidence-based interventions and treatments specific to the diagnosis or problem. Provides holistic care that addresses the needs of diverse populations across the lifespan. Advocates for health care that is sensitive to the needs of healthcare consumers, with particular emphasis on the needs of diverse populations. Applies appropriate knowledge of major health problems and cultural diversity in implementing the plan of care. Applies available healthcare technologies to maximize access and optimize outcomes for healthcare consumers. Utilizes community resources and systems to implement the plan. Collaborates with healthcare providers from diverse backgrounds to implement and integrate the plan. Accommodates for different styles of communication used by healthcare consumers, families, and healthcare providers. Integrates traditional and complementary health care practices as appropriate. Implements the plan in a timely manner in accordance with patient safety goals. Promotes the healthcare consumer s capacity for the optimal level of participation and problemsolving. Documents implementation and any modifications, including changes or omissions, of the identified plan. Standard 5A. Coordination of Care The registered nurse coordinates care delivery. Competencies The registered nurse: Organizes the components of the plan. Manages a healthcare consumer s care in order to maximize independence and quality of life. Assists the healthcare consumer in identifying options for alternative care. Communicates with the healthcare consumer, family, and system during transitions in care. Advocates for the delivery of dignified and humane care by the inter-professional team. Documents the coordination of care. Standard 5B. Health Teaching and Health Promotion The registered nurse employs strategies to promote health and a safe environment. Competencies The registered nurse: Provides health teaching that addresses such topics as healthy lifestyles, risk-reducing behaviors, developmental needs, activities of daily living, and preventive self-care. Uses health promotion and health teaching methods appropriate to the situation and the healthcare 10

11 consumer s values, beliefs, health practices, developmental level, learning needs, readiness and ability to learn, language preference, spirituality, culture, and socioeconomic status. Seeks opportunities for feedback and evaluation of the effectiveness of the strategies used. Uses information technologies to communicate health promotion and disease prevention information to the healthcare consumer in a variety of settings. Provides healthcare consumers with information about intended effects and potential adverse effects of proposed therapies. Standard 6. Evaluation The registered nurse evaluates progress toward attainment of outcomes. Competencies The registered nurse: Conducts a systematic, ongoing, and criterion-based evaluation of the outcomes in relation to the structures and processes prescribed by the plan of care and the indicated timeline. Collaborates with the healthcare consumer and others involved in the care or situation in the evaluation process. Evaluates, in partnership with the healthcare consumer, the effectiveness of the planned strategies in relation to the healthcare consumer s responses and the attainment of the expected outcomes. Uses ongoing assessment data to revise the diagnoses, outcomes, the plan, and the implementation as needed. Disseminates the results to the healthcare consumer, family, and others involved, in accordance with federal and state regulations. Participates in assessing and assuring the responsible and appropriate use of interventions in order to minimize unwarranted or unwanted treatment and healthcare consumer suffering. Documents the results of the evaluation. ANA Standards of Professional Performance Standard 7. Ethics The registered nurse practices ethically. Competencies The registered nurse: Uses Code of Ethics with Interpretive Statements (ANA, 2001) to guide practice. Delivers care in a manner that preserves and protects healthcare consumer autonomy, dignity, rights, values, and beliefs. Recognizes the centrality of the healthcare team consumer and family as core members of any healthcare team. Upholds healthcare consumer confidentiality within legal and regulatory parameters. Assists healthcare consumers in self-determination and informed decision-making. Maintains a therapeutic and professional healthcare consumer-nurse relationship within appropriate professional role boundaries. Contributes to resolving ethical issues involving healthcare consumers, colleagues, community groups, systems, and other stakeholders. Takes appropriate action regarding instances of illegal, unethical, or inappropriate behavior that can endanger or jeopardize the best interests of the healthcare consumer or situation. Speaks up when appropriate to question healthcare practice when necessary for safety and quality improvement. Advocates for equitable healthcare consumer care. 11

12 Standard 8. Education The registered nurse attains knowledge and competence that reflects current nursing practice. Competencies The registered nurse: Participates in ongoing educational activities related to appropriate knowledge bases and professional issues. Demonstrates a commitment to lifelong learning through self-reflection and inquiry to address learning and personal growth needs. Seeks experiences that reflect current practice to maintain knowledge, skills, abilities, and judgment in clinical practice or role performance. Acquires knowledge and skills appropriate to the role, population, specialty, setting, role, or situation. Seeks formal and independent learning experiences to develop and maintain clinical and professional skills and knowledge. Identifies learning needs based on nursing knowledge, the various roles the nurse may assume, and the changing needs of the population. Participates in formal or informal consultations to address issues in nursing practice as an application of education and a knowledge base. Shares educational findings, experiences, and ideas with peers. Contributes to a work environment conducive to the education of healthcare professionals. Maintains professional records that provide evidence of competence and lifelong learning. Standard 9. Evidence-Based Practice and Research The registered nurse integrates evidence and research findings into practice Competencies The registered nurse: Utilizes current evidence-based nursing knowledge, including research findings, to guide practice. Incorporates evidence when initiating changes in nursing practice. Participates, as appropriate to education level and position, in the formulation of evidence-based practice through research. Shares personal or third-party research findings with colleagues and peers. Standard 10. Quality of Practice The registered nurse contributes to quality nursing practice. Competencies The registered nurse: Demonstrates quality by documenting the application of the nursing process in a responsible, accountable, and ethical manner. Uses creativity and innovation to enhance nursing care. Participates in quality improvement. Activities may include: o Identifying aspects of practice important for quality monitoring; o Using indicators to monitor quality, safety, and effectiveness of nursing practice; o Collecting data to monitor quality and effectiveness of nursing practice; o Analyzing quality data to identify opportunities for improving nursing practice; o Formulating recommendations to improve nursing practice or outcomes; o o Implementing activities to enhance the quality of nursing practice; Developing, implementing, and/or evaluating policies, procedures, and guidelines to improve the quality of practice; 12

13 o o o o o o Participating on and/or leading Interprofessional teams to evaluate clinical care or health services; Participating in and/or leading efforts to minimize costs and unnecessary duplication; Identifying problems that in day-to-day work routines in order to correct process inefficiencies; Analyzing factors related to quality, safety, and effectiveness; Analyzing organizational systems for barriers to quality healthcare consumer outcomes; and Implementing processes to remove or weaken barriers within organizational systems. Standard 11. Communication The registered nurse communicates effectively in a variety of formats in all areas of practice. Competencies The registered nurse: Assesses communication format preferences of healthcare consumers, families, and colleagues. Assesses her or his own communication skills in encounters with healthcare consumers, families, and colleagues. Seeks continuous improvement of communication and conflict resolution skills. Conveys information to healthcare consumers, families, the Interprofessional team, and others in communication formats that promote accuracy. Questions the rationale supporting care processes and decisions when they do not appear to be in the best interest of the patient. Discloses observations or concerns/related to hazards and errors in care or the practice environment to the appropriate level. Maintains communication with other providers to minimize risks associated with transfers and transition in care delivery. Contributes her or his own professional perspective in discussions with the Interprofessional team. Standard 12. Leadership The registered nurse demonstrates leadership in the professional practice setting and the profession. Competencies The registered nurse: Oversees the nursing care given by others while retaining accountability for the quality of care given to the healthcare consumer. Abides by the vision, the associated goals, and the plan to implement and measure progress of an individual healthcare consumer or progress within the context of the healthcare organization. Demonstrates a commitment to continuous, lifelong learning and education for self and others. Mentors colleagues for the advancement of nursing practice, the profession, and quality health care. Treats colleagues with respect, trust, and dignity. Develops communication and conflict resolution skills. Participates in professional organizations. Communicates effectively with the healthcare consumer and colleagues. Seeks ways to advance nursing autonomy and accountability. Participates in efforts to influence healthcare policy involving healthcare consu7mers and the profession. 13

14 Standard 13. Collaboration The registered nurse collaborates with healthcare consumer, family, and others in the conduct of nursing practice. Competencies The registered nurse: Partners with others to effect change and produce positive outcomes through the sharing of knowledge of the healthcare consumer and/or situation. Communicates with the healthcare consumer, the family, and healthcare providers regarding healthcare consumer care and the nurse s role in the provision of that care. Promotes conflict management and engagement. Participates in building consensus or resolving conflict in the context of patient care. Applies group process and negotiation techniques with healthcare consumers and colleagues. Adheres to standards and applicable codes of conduct that govern behavior among peers an colleagues to create a work environment that promotes cooperation, respect, and trust. Cooperates in creating a documented plan focused on outcomes and decisions related to care and delivery of services that indicates communication with healthcare consumers, families, and others. Engages in teamwork and team-building process. Standard 14. Professional Practice Evaluation The registered nurse evaluates her or his own nursing practice in relation to professional practice standards and guidelines, relevant statutes, rules, and regulations. Competencies The registered nurse: Provides age-appropriate and developmentally appropriate care in a culturally and ethnically sensitive manner. Engages in self-evaluation of practice on a regular basis, identifying areas of strength as well as areas in which professional growth would be beneficial. Obtains informal feedback regarding her or his own practice from healthcare consumers, peers, professional colleagues, and others. Participates in peer review as appropriate. Takes action to achieve goals identified during the evaluation process. Provides the evidence for practice decisions and actions as part of the informal and formal evaluation processes. Interacts with peers and colleagues to enhance her or his own professional nursing practice or role performance. Provides peers with formal or informal constructive feedback regarding their practice or role performance. Standard 15. Resource Utilization The registered nurse utilizes appropriate resources to plan and provide nursing services that are safe, effective, and financially responsible. Competencies The registered nurse: Assesses individual healthcare consumer care needs and resources available to achieve desired outcomes. Identifies healthcare consumer care needs, potential for harm, complexity of the task, and desired 14

15 outcome when considering resource allocation. Delegates elements of care to appropriate healthcare workers in accordance with any applicable legal or policy parameters or principles. Identifies the evidence when evaluating resources. Advocates for resources, including technology, that enhance nursing practice. Modifies practice when necessary to promote positive interaction between healthcare consumers, care providers, and technology. Assists the healthcare consumer and family in identifying and securing appropriate services to address needs across the healthcare continuum. Assists the healthcare consumer and family in factoring costs, risks, and benefits in decisions about treatment and care. Standard 16. Environmental Health The registered nurse practices in an environmentally safe and healthy manner. Competencies The registered nurse: Attains knowledge of environmental health concepts, such as implementation of environmental health strategies. Promotes a practice environment that reduces environmental health risks for workers and healthcare consumers. Assesses the practice environment for factors such as sound, odor, noise, and light that threaten health. Advocates for the judicious and appropriate use of products in health care. Communicates environmental health risks and exposure reduction strategies to healthcare consumers, families, colleagues, and communities. Utilizes scientific evidence to determine if a product or treatment is an environmental threat. Participates in strategies to promote healthy communities. American Nurses Association (2010). Scope and Standards of Practice (2 nd ed.). Silver Spring, MD: American Nurses Association. ANA Code of Ethics for Nurses The ANA Code of Ethics for Nurses as revised in (2015) follows. The professional issues in the first three statements are concerned with protection of clients' rights and safety; those in the next three pertain to promoting healthy work cultures and self-care. The social issues of the last three statements of the code relates to the nurse's obligations to society and the profession. 1. The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person. 2. The nurse's primary commitment is to the patient, whether an individual, family, group, community, or population. 3. The nurse promotes, advocates for, and protects the rights, health, and safety of the patient. 4. The nurse has the authority, accountability, and responsibility for nursing practice; makes decisions; and takes action consistent with the obligation to promote health and to provide optimal care. 15

16 5. The nurse owes the same duties to self as to others, including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competence, and continue personal and professional growth. 6. The nurse, through individual and collective effort, establishes, maintains, and improves the ethical environment of the work setting and conditions of employment that are conducive to safe, quality health care. 7. The nurse, in all roles and settings, advances the profession through research and scholarly inquiry, professional standards development, and the generation of both nursing and health policy. 8. The nurse collaborates with other health professionals and the public to protect human rights, promote health diplomacy, and reduce health disparities. 9. The profession of nursing, collectively through its professional organizations, must articulate nursing values, maintain the integrity of the profession, and integrate principles of social justice into nursing and health policy. American Nurses Association (2015). Code of ethics for nurses with interpretive statements. Silver Springs, MD: Nursebooks.org PROFESSIONAL BEHAVIOR AND SAFE NURSING CARE EXPECTATIONS Throughout this program the student will be required to demonstrate professional behavior and safe nursing care. The student will in no instance demonstrate any unsafe or potentially unsafe behavior that could endanger not only the physical well-being, but also the emotional well-being of any client, family member, faculty, staff, or peer. Unsafe behavior includes, but is not limited to, being under the influence of drugs or alcohol, failing to use Standard Precautions at all times, failing to apply basic safety rules, such as leaving side rails on beds and cribs down, failing to report an abnormal finding, and not submitting required clinical immunization, background check, and drug testing data in a timely manner. Unsafe behavior is the failure to perform in the manner that any prudent student nurse, at the same level of preparation, would perform in a particular clinical situation. Individual course supplements may designate other specific behaviors considered unsafe in specific settings. Students are expected to be familiar with all information that is published in the course supplements, course syllabi, and student guidelines. Failure to read this material cannot be cited as a reason for non-compliance with information that promotes safe and professional nursing practice. Students who exhibit behavior and/or performance that is potentially or actually unsafe or unprofessional will be immediately removed from clinical and classroom settings. Unsafe practice or unprofessional behavior can result in a failing grade for the course regardless of the course grade earned academically. Students in the nursing program are expected to adhere to professional standards in their experiences and relationships with nursing faculty, agency staff, clients and family members. The student will in no instance demonstrate any behavior deemed unprofessional or inappropriate by the nursing faculty or agency staff. Professional behavior includes, but is not limited to, following directions, adequate 16

17 preparation for clinical, meeting deadlines for assignments, communicating appropriately and in a timely manner, following professional dress expectations, meeting appointments, being on time, and truthfulness in all statements or documentation. Academic dishonesty and plagiarism will result in a failing course grade and likely removal from the nursing program. The BSN is a degree that signifies readiness for beginning professional nursing practice. The faculty recognizes a responsibility to both the student and potential patients to produce graduates whose attitudes and behavior indicate suitability for carrying out their professional functions. If unprofessional behavior is exhibited, the Director of the School of Nursing, in consultation with the Executive Committee of the School of Nursing, will determine if, and under what conditions the student can continue in the nursing program. If, in the best professional judgment of the Executive Committee, a student appears to be unsafe or potentially dangerous to patients and colleagues, the School will refuse to allow the student in the practice setting, thus preventing him/her from completing the program. NEW GRADUATE REQUIREMENTS Proof of California licensure as an RN is required prior to commencement of the fall semester immediately after the student enters the program (approximately 3 months after program entry). If proof of RN status is not provided by the day of orientation to the fall semester, the student will not be allowed to take classes. The student must apply for a Personal Educational Leave or be dropped from the program. Some coursework in the RN to BSN Program draws upon work experience as an RN. Any new graduate RN or RN without work experience as an RN (in any setting) must apply to enroll in the Rural California Nursing Preceptorship (RCNP) program, or equivalent as determined by the RN to BSN Advisor, by the September RCNP deadline (as shown on the RCNP website), following students first summer session of the program. This nursing preceptorship will take place during the winter session. Information about this preceptorship, including costs, can be found on the RCNP website: Candidates for the Winter RCNP program are selected from the applicants who have applied by the September deadline. Those RN to BSN students who apply but are not chosen to participate in the RCNP Program will work with the RN to BSN Advisor on other potential options. HEALTH POLICIES AND REGULATIONS To enter into and to complete the nursing program, students must be able to meet the emotional and physical requirements of the School. Emotional Requirements The student must have sufficient emotional stability to perform under stress produced by both academic study and the necessity of performing nursing care in real patient situations while being observed by the instructors and other health care personnel. Physical Requirements In order to participate in CSU, Chico's Nursing Program, students are required to travel to agencies and hospitals, and to homes with unpredictable environments. Students need to have the endurance to adapt to a physically and emotionally demanding program. The following physical requirements would be necessary to participate in the clinical application courses in nursing: 17

18 1. Strength: Sufficient strength to lift, move and transfer most patients; to restrain and carry children; to move and carry equipment; and to perform CPR that requires sufficient body weight and adequate lung expansion. 2. Mobility: Sufficient to bend, stoop, get down on the floor; combination of strength, dexterity, mobility and coordination to assist patients; ability to move around rapidly. 3. Fine Motor Movements: Necessary to manipulate syringes and IVs; to assist patients with feeding and hygiene; to write in charts; to perform sterile procedures and other skilled procedures. 4. Speech: Ability to speak clearly in order to communicate with staff, physicians, and patients; need to be understood on the telephone. 5. Vision: Sufficient to make physical assessments of patients and equipment; to read. 6. Hearing: Sufficient to accurately hear on the telephone, to be able to hear through the stethoscope to discriminate sounds. 7. Touch: Ability to palpate both superficially and deeply and to discriminate tactile sensations. 8. Health: Nursing is considered to be a high risk profession for exposure to Hepatitis B and other contagious diseases. Immunizations required by the School of Nursing reduce this risk for nursing students, but do not eliminate it entirely. Pregnant students need a physician's note to participate in the clinical course in the program. Students with impaired or deficient immune systems may be at risk for contracting serious diseases. Such students must have physician approval for participation in clinical courses, and must discuss their situation with the clinical instructor. REPORTING OF ILLNESS OR ACCIDENT 1. In the event of illness or accident, the student should notify the School Office; if unable to attend laboratory assignment, the student must notify the clinical instructor. Exposure to any contagious disease must be reported immediately to the appropriate clinical instructor. 2. If physical illness and/or emotional problems are noted by the instructor to be interfering with a student's ability to function in either the classroom or clinical area, the student may be required to obtain a physical examination and/or counseling, as appropriate, in order to continue in the course. 3. In case of illness, students are responsible to provide their own medical care. 4. If a student is involved in an accident occurring either on campus or during a clinical session, the student should report that accident to his/her instructor immediately. In addition, the student should obtain treatment at the closest appropriate health care facility. Students are fully responsible for all treatment costs (that is part of the reason that health insurance is required). 5. An accident form and liability paperwork must be filled out within 24 hours of the accident and submitted to the Director of the School of Nursing. 6. For needlesticks and/or potential infectious exposures, the Bloodborne Pathogen Policy will be followed. 18

19 CLINICAL AGENCY REQUIREMENTS The following requirements must be completed during the spring semester (typically 6-7 months after program entry) of the RN-BSN program and, when appropriate, updated. No student may attend the first day of a clinical course (including orientation) unless all requirements are met. Clinical requirements must remain current throughout the academic semester enrolled. Students must submit verification of these requirements to CertifiedBackground.com (See Appendix B Using CertifiedBackground.com for Background Check, Drug Screen, and Tracking Immunizations). Background Checks and Drug Testing To participate in clinical courses, all students in the program must have a background check and 10-panel drug screen completed through Certified Profile (See Appendix B Using CertifiedBackground.com for Background Check, Drug Screen, and Tracking Immunizations). By virtue of your enrollment in the program, you are authorizing CSU, Chico School of Nursing to release any and all information contained in your background check and drug screen to any clinical facility that may require this information to approve your participation in clinical courses there. The background check searches multiple databases including the following: Residency History Search County Criminal Records Statewide Criminal Records Nationwide Sexual Offender Index Social Security Verifications Nationwide Healthcare Fraud & Abuse Scan Medicare & Medicaid Sanctioned, Excluded Individuals Office of Research Integrity (ORI) Office of Regulatory Affairs (ORA) FDA Debarment Check State Exclusion List Office of Inspector General (OIG)-List of Excluded Individuals/Entities General Services Administration (GSA)-Excluded Parties List Any prior convictions related to child abuse, sexual abuse, etc. may result in students being barred from access to clinical settings that involve vulnerable populations. If you have concerns about your background check, please see the Director of the School of Nursing. No other background clearances you may have received can be used to meet this requirement. Health Insurance Some diseases or injuries you may risk could require long-term hospitalization and care. Therefore, supplemental major medical insurance coverage is required for all students. If you receive financial aid, you may include the added cost of the insurance on your financial aid request. Several nursing students experience needle sticks each year. Since the School of Nursing policy for needle stick and other blood-borne pathogen exposures may involve an emergency room visit and may require an initial course of anti-hiv drugs started within one hour, complete insurance coverage is especially important. These costs could easily reach $300 or more for the initial incident. It can become quite expensive, should you have to start on anti-hiv drugs for a prolonged period. 19

20 Clinical agencies used for practica typically do not provide free services to you for emergency treatment if you are injured in that agency. If such care is given, you will be billed by the treating hospital or agency. Therefore, each student is responsible to determine that health insurance coverage includes provisions for emergency room visits in the event of a needle stick or other high-risk exposure in the clinical setting, as well as for costs of any anti-hiv drugs, if a physician determines they are warranted. For example, Kaiser insurance coverage does not always extend to emergency room visits out of their area of service. Automobile Access and Insurance Laboratory experiences are in various settings such as health departments and schools throughout Butte County and surrounding counties, and require that students have access to a car. Some clinical facilities may be considerable distances from the Chico campus.. A current driver's license and automobile registration are mandatory. The car MUST be insured with an agency that is registered in the State of California. Currently, the minimum acceptable coverage is for bodily injury of $15,000/$30,000 and for damage to the property of a third person of $10,000. The public health agencies require an Affidavit of Coverage in order for the student to be assigned for experience. Insurance verification is required in all semesters of the nursing program prior to enrolling in clinical courses. Cardio-Pulmonary Resuscitation (CPR) You must hold a current class "C" or professional CPR card that includes certification in two-man CPR, infant and child, obstructed airway, and use of an AED during the entire nursing program. Immunizations The School of Nursing at CSU, Chico requires all new students to have the following immunizations and tests completed no later than mid spring semester (or as specified by the RN to BSN Advisor/Coordinator) before they begin their public health clinical practicum, and they are to be kept current throughout the completion of the program that August. Any needed immunizations may be obtained at the Student Health Center on campus, the Butte County Public Health Department (phone for appointment), or by a healthcare provider of your choice. Note that it is assumed that all new students have previously received the usual childhood immunizations (which are required during public school attendance) for: diphtheria, tetanus, whooping cough, measles, mumps and polio. If a student has not had these immunizations, or is unsure, it is highly recommended the student discuss their past immunization history with their personal physician and obtain the appropriate immunizations or have titers drawn to verify immunity. 1. Required Immunizations a. Pertussis (Tdap) booster within the past 5 years unless it was clearly included as part of a recent tetanus immunization. If you are pregnant, please seek the advice of your medical healthcare provider about the advisability of having this vaccine. b. Tetanus booster given within the past ten years. If you need to renew your tetanus for admission to the nursing program and you still need the pertussis booster, be sure to have the Tdap immunization included with your tetanus as one vaccination. c. Annual PPD skin test for TB. Students with negative PPD results need no further evaluation other than an annual PPD skin test. In accord with county and state health policy, if a student has a 20

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